24.1 Critical Thinking with Ken Gillman and the Flying Spaghetti Monster

[00:00:00] Teaching of critical thinking and analytical skills is really much more important than the teaching of knowledge. I mean, almost everything I was taught in medical school is wrong. One of the relatively small number of sensible statements that teachers made to me during my training was precisely that, that almost everything you're taught now will turn out to be wrong.

[00:00:25] Somebody get this guy some help!

[00:00:27] All right, so today Ken Gillman is joining me again. He's an MD, a psychiatrist, a clinical neuropharmacologist, currently living in tropical North Queensland, Australia.

[00:00:47] And after retiring from clinical practice, like a lot of psychiatrists that I've interviewed, he never actually retired, but rather started a website aptly named psychotropical.com.

[00:01:00] Or psychotropical.com. Dr. Gillman provides expert analysis and information about psych drugs written in a way that is useful for both patients and clinicians.

[00:01:12] And importantly, is totally independent of any kind of advertising, or promotion.

[00:01:20] He is one of, if not the world's leading expert on serotonin toxicity, also known to less well-versed folks as serotonin syndrome.

[00:01:31] And Dr. Gillman also ranks very highly in his expertise on MAOIs, or monoamine oxidase inhibitors, an older class of antidepressants that gradually fell out of favor decades ago with the emergence of TCAs, or tricyclic antidepressants.

[00:01:48] And later, the most commonly prescribed class of what the marketing departments of major pharmaceutical companies have dubbed antidepressants in SRIs, or serotonin reuptake inhibitors.

[00:02:00] Dr. Gillman has also been highly critical of the general ways that psychiatric residents and medical students are taught to appraise data,

[00:02:10] as well as the over-reliance and over-confidence on RCTs, or randomized clinical trials.

[00:02:18] Dr. Gillman takes several hours out of his week graciously to respond directly to patients and other providers seeking his counsel, including myself, without ever asking for anything in return, at least not from me.

[00:02:32] I've learned a tremendous amount from being on the MAOI roundtable email chain with some of the most prominent names in the field of psychiatry, discussing complex clinical topics such as treatment-resistant depression, drug-drug interactions, and clinical management of existing patients.

[00:02:52] Thank God, or thank the flying spaghetti monster, one of the two, or whatever entity resides over us spiritually, for Ken's critical thinking skills, his assertiveness with data-driven scientific proclamations,

[00:03:07] and fighting the bias that exists in academic publications and institutions of higher learning, as scientific progress seems to exceedingly get swept to the side in favor of increasing profit margins.

[00:03:22] While the pharmaceutical companies are continually allowed to advertise directly to consumers in the United States,

[00:03:30] Ken and I are trying to combat the profit and power-driven misinformation that exists in the current literature by providing what I call direct-to-consumer education via our online platforms.

[00:03:44] Ken, it's great to see you again. It was good to catch up a minute ago.

[00:03:47] How are you doing this evening or this morning for you?

[00:03:52] Well, hello from the tropics, and I'm very pleased to be talking with you and your listeners again.

[00:04:00] It's getting summer here. We've had very, very dry weather, but we had a storm last night, so we've had, I think, a good inch of rain.

[00:04:10] So, yeah. The flying spaghetti monster.

[00:04:15] I didn't know if you'd catch that.

[00:04:17] I did, but do you know where that comes from?

[00:04:20] Yeah, right.

[00:04:21] I believe from Topeka, Kansas.

[00:04:23] I've been subscribing to the two journals, the two relevant journals that are concerned with that.

[00:04:32] The American Skeptics Journal and the Australian one.

[00:04:36] The Australian Skeptics Journal is very good.

[00:04:39] They've published a lot of great stuff over the years.

[00:04:42] I've subscribed to those for as long as I've subscribed to Scientific American and New Scientist.

[00:04:49] For those who don't know, the flying spaghetti monster, it was one of the universities in the United States that was teaching creationism, the Christian doctrine of our past and our history.

[00:05:03] And somebody wrote a very poignant letter stating that they had to also teach the mythology of the flying spaghetti monster, right?

[00:05:13] Maybe you could give a little bit more context there.

[00:05:15] My memory's failing me here.

[00:05:16] There have been so many things like this over the decades that I can't remember the details of all of them, Ethan.

[00:05:23] But I think that originated from one of the people who were deep in the sceptical publishing movement, either one of the people concerned with the American.

[00:05:35] Actually, it might have been the Australian Journal originated that one.

[00:05:39] And if you could probably, sure, look, Google's getting, actually, Google's getting worse in a way, isn't it?

[00:05:46] The general ability to find information on the internet.

[00:05:49] Let's try to stop automatically saying Google.

[00:05:53] They've got us mesmerized, haven't they?

[00:05:55] But search the internet and you'll find the origin of the flying spaghetti monster.

[00:06:01] I got a sneaky feeling I know who it was.

[00:06:03] And I think it was one of the Australian guys concerned with the Australian Skeptic magazine.

[00:06:08] It says the flying spaghetti monster was first described in a satirical open letter written by Bobby Henderson in 2005 to protest the Kansas State Board of Education decision to permit teaching intelligent design as an alternative to evolution.

[00:06:26] It's also known as Pastafarianism.

[00:06:29] Yes, that's it.

[00:06:30] Yes, yes.

[00:06:31] I love that one.

[00:06:32] Because it goes to the heart of something you mentioned before, which is that teaching of critical thinking and analytical skills is really much more important than the teaching of knowledge.

[00:06:45] I mean, almost everything I was taught in medical school is wrong.

[00:06:50] One of the relatively small number of sensible statements that teachers made to me during my training was precisely that, that almost everything you're taught now will turn out to be wrong.

[00:07:01] Well, and to just add to that, I find it really interesting that you go through the medical school process and it's predicated on having the right answer or enough of the right answers to get to pass your classes and to get through that whole process.

[00:07:16] I think it can really get ingrained within us that there are right answers to every question as opposed to multiple avenues that could turn out to be right or could turn out to be wrong.

[00:07:29] Yes, knowledge is a journey, not a destination.

[00:07:33] Yeah, absolutely.

[00:07:35] Before we get to more pressing questions about the field of psychiatry as a whole, we got to know you in Renegade Psych's first ever interview, an audio series published in October of 2023.

[00:07:47] You've always struck me as somebody who has not been afraid to speak your mind and state your piece.

[00:07:54] So I was curious about a time long before you ever entered into the field of medicine as a child or an adolescence.

[00:08:03] Can you tell us about a time that your boldness got you into trouble?

[00:08:09] Yes, I think the first recollection I have of this relates to the flying spaghetti monster.

[00:08:18] Because, of course, going to an English public school that was Anglican, when you got to about 11 years old or something, you did something that I think was called confirmation.

[00:08:29] Confirmation. And that was where you were supposed to be old enough to confirm what your godparents had done when they christened you and all that sort of thing.

[00:08:38] So you had to learn the, I think it was called the catechism, wasn't it?

[00:08:43] There were a whole lot of, I can't remember anything about it at all.

[00:08:45] So you had to go to special confirmation classes.

[00:08:48] And then when you'd learnt all the stuff, you know, the bishop came and laid his hand on you.

[00:08:53] And we had a lovely chapel at the school I was at.

[00:08:57] It was lovely.

[00:08:58] They wouldn't allow me to sing, though.

[00:09:01] But anyway, so these classes, confirmation classes, hadn't got very far along before the fellow running them got so sick of all the difficult questions that I was asking.

[00:09:13] You know, did animals have souls?

[00:09:16] Did the church believe in evolution?

[00:09:20] So at what point in evolution did souls appear in apes or proto-humans?

[00:09:25] So it was all too difficult.

[00:09:27] So they told me to stop coming to confirmation classes.

[00:09:32] Either that or they just didn't want to hear you sing.

[00:09:34] I suppose I got into trouble.

[00:09:35] I didn't actually get into trouble for that actively.

[00:09:38] But, you know, it was the first clear thing I remember.

[00:09:43] You know, the establishment didn't take well to criticism.

[00:09:48] Well, not criticism, but to doubt and questioning.

[00:09:52] Well, you know, you stood counter to the indoctrination into the church.

[00:09:57] So there was a lot of others that if you'd have stayed in that class, they may not have been good God-fearing Christians at this point.

[00:10:06] Not that there's anything wrong with religion.

[00:10:08] I just like to keep an open mind about things.

[00:10:10] And I had a similar experience growing up.

[00:10:13] I was the only person in my immediate and extended family.

[00:10:18] We grew up Baptist that never got baptized.

[00:10:21] Because there were too many things that didn't add up for me.

[00:10:25] And I just couldn't go through with it.

[00:10:28] To me, the key thing is not the belief, but the way of thinking that creates that belief.

[00:10:36] In other words, accepting things without sound evidence.

[00:10:41] And going back, I think, to something we touched on before, this whole business of critical thinking.

[00:10:47] It's about the ability to assess the probity and the provenance of the evidence that you're being presented with.

[00:10:58] You know, it's just like buying an antique.

[00:11:01] You know, if it hasn't got definite provenance and you don't have faith in the probity of the person who's dealing with it,

[00:11:09] well, then you shouldn't be buying it.

[00:11:11] Same principles in operation, isn't it?

[00:11:14] Yeah, it certainly does not necessarily breed good critical thinking skills.

[00:11:19] Because it doesn't necessarily work towards the goal of presenting that information.

[00:11:24] You know, I've never thought of it like that.

[00:11:25] But there's a lot of parallels to training in medical institutions across the world nowadays.

[00:11:32] You know, I think an interesting aspect of this is the way people become personally attached to their pet theories or whatever they are latched onto at the time.

[00:11:46] I often say to myself, if somebody came along and said, look, Gilman, this whole thing about serotonin toxicity that you claim to be an expert in,

[00:11:58] you've just got it completely wrong.

[00:12:00] We've proved it's nothing to do with serotonin and 5-H2 receptors.

[00:12:04] It's all to do with something else.

[00:12:06] I would say, fantastic.

[00:12:08] How interesting.

[00:12:09] Tell me all about it.

[00:12:10] I wouldn't be offended because they'd criticised my idea.

[00:12:16] And this is something that's always struck me and I've always, not always, but I've tended to use as a criteria to assess what I think of the intellect of the people I interact with.

[00:12:29] If when you produce evidence or criticise something that they reckon is true, I try to avoid the word belief.

[00:12:40] If somebody says, what do you believe?

[00:12:42] I say, well, I don't think belief is the right word.

[00:12:46] I think what we try to do is assess the available evidence as objectively as possible, recognising that true objectivity may be an elusive beast.

[00:12:57] And really, that's what it's all about.

[00:13:00] So people who get offended, taking offence is the widespread phenomena we have nowadays, isn't it?

[00:13:11] Everybody likes to take offence at everything.

[00:13:14] But people who are offended because you criticise their intellectual output clearly aren't thinking objectively.

[00:13:22] You know, I am not my ideas about serotonin toxicity.

[00:13:27] They're just how I've interpreted the evidence that's available.

[00:13:31] If somebody produces new evidence and suggests a better way of interpreting it that puts a different light on it, I shall be delighted.

[00:13:39] As we said, science is a journey, not a destination.

[00:13:42] Yeah, I think to your point about people who get so stuck in one belief or one truth, I think part of it is a product of the linguistics that's involved in our brains or neuro linguistics.

[00:13:57] You know, this more animal part of our brain, this limbic system seems to try to order information in all or nothing type of terms in fact or not fact, good enough or I'm not good enough.

[00:14:09] And I think that extends over if you don't have the conscious ability to welcome that information and guide that information towards the middle ground that it usually is the truth.

[00:14:23] It's a lot easier mentally to know where you stand than to say, you know what, I may be wrong and the opposite truth may be wrong as well.

[00:14:34] Let me look at the evidence.

[00:14:36] Let me think critically and find the happy medium in between this argument.

[00:14:40] Yes.

[00:14:42] As you were talking, it made me think immediately of Theodore Dobzhansky.

[00:14:48] The way we think must surely be a product of evolution.

[00:14:53] You know, if you're in the jungles in Africa half a million years ago or whatever, and you see a flickering shadow behind the bushes, it pays to assume that it might be a leopard.

[00:15:06] If you start philosophizing over what color it is and why it's moving and all the rest of it, you'll be lunched.

[00:15:14] So our brains have evolved to make maximum use of our relatively poor real-time information processing ability.

[00:15:24] It's actually very poor and savers from situations like that by making a whole lot of extraordinarily clever and efficient and energy-saving shortcuts in the way we perceive the world and react to it, which allow us to survive.

[00:15:42] So it would be staggering if substantial aspects of the way our brains work isn't still dependent on that kind of thing.

[00:15:54] And the reason it made me think of this wonderful man, Theodore Dobzhansky.

[00:16:00] He was a Ukrainian who went into America in the early part of the last century.

[00:16:06] I can't remember his dates, but they were probably in 1900 to 1970 or vaguely that area.

[00:16:13] And he was a very distinguished evolutionary biologist.

[00:16:17] And the lovely quote from him that I love is,

[00:16:22] Nothing in biology makes sense except through the lens of evolution.

[00:16:27] And I latched onto that immediately when I saw it, only a decade or so ago.

[00:16:33] Because for many, many years, I've had the view that a lot of things in medicine don't make sense,

[00:16:40] unless you look at them through the evolutionary view.

[00:16:44] He would have said the same about medicine, obviously, if he was saying it about biology.

[00:16:48] And that for sure is true.

[00:16:51] And I've always thought that we don't pay enough attention to how our evolutionary past affects medicine.

[00:16:59] I believe at one time, I don't know if it still exists,

[00:17:01] there was actually a journal of medical evolution or something.

[00:17:05] So I think recognizing that influences the way we understand how we think.

[00:17:13] And yeah, that's important.

[00:17:16] So I will use this example with patients often to try to shake them out of that all or nothing stances.

[00:17:23] And, you know, I'll say,

[00:17:25] How would you feel if you didn't get invited to the movies and all of your friends got invited to the movies,

[00:17:30] but they didn't call you?

[00:17:32] And, you know, oh, I'd feel bad.

[00:17:34] I say, well, would you feel like your life is threatened?

[00:17:37] Well, no.

[00:17:38] I say, are you sure you wouldn't even feel a touch of your life being threatened in that situation?

[00:17:43] And then I say, well, let's go back to living in that cave, you know, tens of thousands of years ago.

[00:17:49] You get kicked out of the cave.

[00:17:51] You're kind of fucked.

[00:17:52] You're probably not going to make it out there,

[00:17:55] but you're going to get eaten by the leopard on the prairie, right?

[00:17:58] To think that that feeling doesn't extend into the world that we live in now,

[00:18:04] obviously, consciously, we override that.

[00:18:06] We inhibit that impulse that our lives may be threatened because we know consciously we can critically think and reason that that is not the situation.

[00:18:15] But then if you feel like your life is threatened, then consciously you start saying,

[00:18:21] Gosh, I'm so stupid for feeling that way.

[00:18:23] Why would I feel that way?

[00:18:25] My emotions are silly, but there's a very evolutionary basis to it.

[00:18:31] CBT-orientated people call that reframing or something.

[00:18:35] And I burst out laughing as you were talking because you said the leopard jumping out from somewhere.

[00:18:40] And that reminded me that for readers of my material,

[00:18:45] I should let you know that I do slip in deliberate mistakes sometimes just to see if people are paying attention.

[00:18:52] One of them was an example like the one you used about the way the brain recognising things about lions jumping out from the forest.

[00:19:02] And of course, lions don't live in the forest.

[00:19:04] Leopards do.

[00:19:06] He just said leopards in the savannah kind of thing.

[00:19:10] Well, I wish I could say mine was intentional.

[00:19:17] About 10 years after I put that in, which was a long time ago, somebody actually wrote to me and said,

[00:19:24] Look, lions don't live in the forest.

[00:19:26] I wrote back and said, Look, you're the first person in 10 years that's noticed that.

[00:19:33] Oh, that's great.

[00:19:35] I'll tell you what did get me into trouble.

[00:19:37] My tendency to tell practical jokes, well, to not tell practical jokes, to play practical jokes.

[00:19:44] It goes back a long, long way.

[00:19:46] One that nearly got me punched in the face.

[00:19:49] In the latter days when I was at Southampton, before I left the UK,

[00:19:53] I wasn't there for an awfully long time, really.

[00:19:56] It was the time of the Falklands War.

[00:19:59] Maggie Thatcher, bellicose, trying to keep herself in power by starting a foreign war.

[00:20:05] And the Queen Elizabeth was at the docks in Southampton.

[00:20:10] And needless to say, it was requisitioned as the hospital ship.

[00:20:13] And I dare say there were other ships at Southampton that were getting ready to sail.

[00:20:19] And the husband of one of the staff who was in the special boat squadron disappeared about six weeks before the war started.

[00:20:30] I think he finished up on South Georgia Island.

[00:20:34] Amazing stories there.

[00:20:36] Anyway, we had a chap, male nurse, working on the professorial ward,

[00:20:42] who fell into that category of people I used to call overgrown boy scouts.

[00:20:49] And he was in the territorial army.

[00:20:51] A very laudable thing to be in.

[00:20:53] But I'm sure many people will recognise that there's a certain sort of person who takes a special joy in playing soldiers like that.

[00:21:02] And this fellow was absolutely in that mould.

[00:21:05] And I was sitting in my office doing some late evening work, one of which was a report for the Ministry of Defence.

[00:21:14] And I found myself looking at a piece of Ministry of Defence-headed notepaper.

[00:21:22] You could see what's coming up here.

[00:21:25] And just out of the blue, this thought came into my head.

[00:21:28] And I said, what about we send Joe a message telling him he's been called up to act as a medical orderly of the QE2.

[00:21:39] And he's to report to the docs at 0400 tomorrow morning with all his kit.

[00:21:45] And I did it.

[00:21:47] And he fell for it, hook, line and sinker.

[00:21:52] And showed up?

[00:21:54] Yeah, yeah, yeah.

[00:21:57] I had forgotten all about it by halfway through the next morning, whatever.

[00:22:01] Until a sister came rushing up to me and said, Joe's on his way back to the hospital and apparently he's absolutely wild.

[00:22:08] He's going to kill you.

[00:22:11] They hid me in a cupboard somewhere or something.

[00:22:13] I can't even remember the details.

[00:22:16] But this guy did not take it well.

[00:22:21] Did he ever catch up with you?

[00:22:24] Not that I remember.

[00:22:25] No, I don't have any further recollection of what happened.

[00:22:30] Oh, that's hilarious.

[00:22:33] Well, you just mentioned, you know, you said the idea just popped into my awareness.

[00:22:39] I think that's one of the best, coolest things about our minds is, you know, you're taking a test or you're trying to recall something and you're consciously, it's like you're hitting your head against a brick wall.

[00:22:52] I can't remember.

[00:22:53] It's like the minute you let that go and you start to just let the ideas flow from your mind.

[00:22:58] You come up with some of the best ideas like playing a joke on that gentleman and putting it on the defense letterhead to make it look more legitimate.

[00:23:09] That's the best thing about our minds.

[00:23:11] I mean, they're very survival oriented and they'll tell us to be afraid of so many different things.

[00:23:17] But they'll also come up with these great ideas that then you just had to follow through.

[00:23:22] You can't let that idea go.

[00:23:25] Do you know, I've just suddenly thought, I think the tendency to do that is linked to what we were talking about before, which is critical thinking.

[00:23:35] Because the other story I was thinking of telling was to do with the children of one or two old friends who came to visit us here in Australia.

[00:23:44] Because, of course, psychotropical started much earlier than you said in your introduction.

[00:23:49] I really started psychotropical right at the beginning of the Internet.

[00:23:53] And the name suddenly popped up in the group of people who were sitting there trying to think of a name for the website and checking what was registered, what wasn't, and psychotropic and tropical.

[00:24:05] And I was trying to keep in contact with my research associates, so to speak, in Europe and wherever by annoying them, by telling them how wonderfully warm my swimming pool was and all that sort of thing to remind them that I was in the tropics.

[00:24:19] So that was a good way of making people remember me, the psychotropical thing tapped into that.

[00:24:24] So right from the beginning, you know, we harked on the tropical thing and crocodiles in Australia and giant spiders that leap on your face in the middle of the night.

[00:24:33] So when the kids came over, I thought, well, what an excellent way of teaching them critical thinking.

[00:24:39] So we kept playing jokes on them, all to do with crocodiles and snakes and spiders and heaven knows what else.

[00:24:47] And I always used to think what an excellent way of making children question things and think critically is to play tricks on them like that.

[00:24:58] But then afterwards, educate them.

[00:24:59] Look, that can't possibly be true.

[00:25:01] You know, crocodiles don't climb trees, you know, whatever.

[00:25:05] I love having conversations with people who have a very open mindset about these things, because I find that, you know, having these conversations, it's just a repeated ideas popping in or things are framed in a way that I hadn't heard before.

[00:25:21] And it generates something new and novel.

[00:25:23] I just thought, you know, how important is the way that you parent your children?

[00:25:31] And, you know, it's almost like if you don't have a little bit of trauma, if you don't consider, you know, trauma to be a parent who says, no, you're wrong, as opposed to the very permissive parent that their child can never do anything wrong in their lives.

[00:25:46] What kind of chance are they going to have to be a good critical thinker?

[00:25:50] Probably not very likely.

[00:25:51] Yes. Look, I think an eternal question is how much does it depend on the individual and how much does it depend on their education?

[00:26:00] I mean, George Bernard Shaw said people succeed despite their education, not because of it.

[00:26:07] I actually hold to that view a little bit.

[00:26:09] You can take a horse to water, but you can't make it drink.

[00:26:12] Well, look, surely the strongest evidence for this is repeatedly exhibited in these sceptical magazines.

[00:26:18] If you do a survey of all the different unusual things that people believe in, whether it's flat earth or ghosts or, you know, make a list of 10, 20, 30 of the things like that.

[00:26:30] And you look at the percentage of people who believe in them, who've just, you know, flunked out of high school, had a high school education, had a university level education or, you know, above that.

[00:26:42] And the percentage who believe in those things hardly changes.

[00:26:45] There have been lots of surveys of this, and I'm sure they're all a bit different, a bit like political opinion polls.

[00:26:52] But the overwhelming trend is that the difference that education makes to those kinds of beliefs is absolutely minimal.

[00:27:01] I can remember a couple of friends of mine at medical school who both did BSCs in biochemistry, and she was an ardent believer in homeopathy.

[00:27:12] And nothing you could say about dilutions and everything else would shift her belief that, you know, water had a memory or whatever it is.

[00:27:20] You know, these people come up with endless explanations to justify their thinking.

[00:27:25] Absolutely extraordinary.

[00:27:26] Yeah.

[00:27:27] So, you know, level of education seems to have very little to do with people's propensity to believe in things that might be considered by others to be without foundation.

[00:27:41] If we can put it like that politely.

[00:27:44] I knew when you agreed to come back on and talk, I knew that I probably didn't even need to create any sort of outline for this interview because it seems like you and I just bounce from,

[00:27:56] the topic about psychiatry to the flying spaghetti monster to consciousness to, it really is a lot of fun.

[00:28:03] But before we get too off the rails, tell me a little bit about what you've been working on in the years since I last talked to you.

[00:28:11] Really?

[00:28:11] I'm winding down a little bit.

[00:28:13] It's my 74th birthday in a week or two's time.

[00:28:16] For anybody who wants to send me a bottle of champagne, it's December the 11th.

[00:28:21] The address is...

[00:28:26] Are you a bourbon guy?

[00:28:28] No, not really.

[00:28:30] Look, I do occasionally have a glass of cognac after dinner, but I'm not really a spirits man.

[00:28:36] I'm really a wine man.

[00:28:39] Just off my right shoulder here, that white book that's right on the edge of the postie there, that's the latest tome of nearly a thousand pages of the latest reviews of champagne.

[00:28:54] So consult that book before you send me the champagne.

[00:28:57] I've got to score four stars or better, all right?

[00:29:00] Is that entire row alcohol books?

[00:29:03] Because I see wine back there too.

[00:29:05] I have quite a lot of books on wine.

[00:29:08] Well, didn't I tell you before?

[00:29:10] I nearly went into the wine trade rather than staying in medicine.

[00:29:13] I don't think so, no.

[00:29:16] Oh, look, I talk to so many people in so many places, I can't remember who I've told what to.

[00:29:20] It's a good thing it's all truthful, otherwise I'd be proved to be a liar.

[00:29:26] That again loops back onto what we were saying before.

[00:29:30] And the reason for that was precisely because, certainly in London in my day, a majority of people who went into psychiatry were not what you would describe as la crème de la crème.

[00:29:43] And I remember sitting in one big grand rounds type meeting where there were probably, you know, about a dozen consultants for different parts of the system.

[00:29:51] And I remember looking around, one, two, three, four, and I think, no, idiot, personality disorder, useless, old granny.

[00:29:59] I could work with him.

[00:30:01] When I got to the end of the row, I thought, really, two people here I could imagine sharing my professional life with.

[00:30:08] The rest of them, I'd lose it.

[00:30:10] I'd slap them around the face or whatever, you know.

[00:30:13] Some of them were absolutely hopeless.

[00:30:16] They really were.

[00:30:17] It was embarrassing.

[00:30:18] So I thought, oh, damn this.

[00:30:20] I'm going to give this up.

[00:30:21] It's awful.

[00:30:22] I had a lot of friends in the wine trade.

[00:30:25] That tells you something about my character, I suppose.

[00:30:28] From my teen years, I had contacts in the wine trade.

[00:30:31] And I set up a wine company in London and was about to quit medicine and go into the wine trade.

[00:30:37] It's fascinating, isn't it?

[00:30:39] How many doctors are like that?

[00:30:41] It's not the exception.

[00:30:42] It's almost the rule, isn't it?

[00:30:44] Everywhere you look in the wine trade, the medical people are deep in it.

[00:30:50] And there's another wonderful example of assessing evidence, setting aside one's preconceptions and emotional attachments and so on and so on.

[00:31:01] And that's the dangers of alcohol.

[00:31:04] Of course, Dave Nutt.

[00:31:06] I taught Dave Nutt, Professor Nutt, Imperial College.

[00:31:09] I hope most people know who he is.

[00:31:11] If they don't, they should.

[00:31:12] But I taught Dave briefly when I was teaching at Guy's.

[00:31:17] Dave was at Bristol.

[00:31:20] He built up the department doing research at Bristol and then moved on to be the professor at Imperial College in London, which is a very prestigious chair.

[00:31:29] And as I'm sure many people know, Dave's done a tremendous amount of excellent work.

[00:31:34] And his department, of course, with Cathart Harris, I think his name is, done a lot of work on psilocybin and all that sort of thing in therapy and PTSD and whatever.

[00:31:46] I don't claim to be up to date with that, but that's certainly it.

[00:31:49] Well, Dave was the chairman of the committee that advised the government on drug policy.

[00:31:56] And are you aware of this?

[00:31:58] Do you know what happened to Dave?

[00:31:59] It's about a decade ago.

[00:32:00] I remember speaking to Dave one day and saying to him that ecstasy was, you know, really not something to worry about.

[00:32:08] And if parents said to me, well, you know, should I worry about my kids having ecstasy when they're at a party or something?

[00:32:15] I used to say to them, well, look, frankly, I would worry far more about who's driving them home afterwards rather than whether they take ecstasy at the party.

[00:32:24] Because the chance of them killed or injured on the way home in a car is a hundred, a thousand times greater than them coming to any harm from taking ecstasy.

[00:32:34] Unless it's contaminated with something.

[00:32:36] The only thing I can think of is dancing all night, sweating everything out and drinking way too much water without any sort of salt with it.

[00:32:45] Exactly.

[00:32:46] Yes, that's been a major problem.

[00:32:49] So I wanted to add just a little bit of context to the end of my and Ken Gilman's discussion.

[00:32:55] When he brought up David Nutt, who is the former chair of the British National Advisory Council on the Misuse of Drugs and tasked to make recommendations about how drugs should be classified.

[00:33:08] Well, his views in the data that you just saw flash up on the screen about how he ranked different drugs according to their dangerousness.

[00:33:16] That was part of a larger conversation that Ken and I were having about how science is increasingly not being driven by data and research, but rather by political interests and aspirations.

[00:33:30] David Nutt lost his position because he put out a report that was driven by data to describe the dangerousness associated with each class of drugs.

[00:33:41] It was very apparent that he offended the home secretary, Jackie Smith, when he accurately pointed out the fact that riding a horse was responsible for 100 deaths per year, while the use of ecstasy for only 30 deaths per year.

[00:33:58] David Nutt and myself were and are in no way, shape or form advocating that these drugs are not harmful or encouraging people to use illicit drugs.

[00:34:10] There are significant dangers of all illicit drugs.

[00:34:14] And some very significant dangers associated with illicit drugs like tobacco and alcohol.

[00:34:20] What we're advocating for is being able to accurately educate the general public on the actual dangerousness and risks associated with different drugs.

[00:34:33] As opposed to just using this fear mongering bullshit and masquerading around like it's data driven instead of another effort to just appease your constituencies.

[00:34:47] By the way, it also calls into question the entire system.

[00:34:53] When a young person goes against the grain, rebels, uses a drug like ecstasy or marijuana, and their experience is not consistent with what they've been taught through fear mongered data from a young age.

[00:35:08] Drug policy should be data driven.

[00:35:12] It should be determined based on sound scientific evidence and research.

[00:35:17] And certainly, David Nutt's opinion, a psychiatrist with decades of experience working in mental health and addiction, who knows the pharmacology associated with illicit drug use, should trump Jackie Smith's, somebody who has no clinical experience of any kind, much less in treating addiction or education on evaluating scientific data and research.

[00:35:45] I have similarly been critical of the way we classify drugs here in America, which is not at all scientifically based and does not accurately reflect the true dangerousness of each drug class.

[00:36:00] Cannabis, MDMA or ecstasy, LSD colloquially known as acid, and psilocybin or magic mushrooms are all schedule one narcotics.

[00:36:12] While methamphetamine and cocaine, which kill tens of thousands of people a year, especially since the cutting everything with fentanyl epidemic emerged, and are so damaging in so many other ways, both of those drugs are scheduled too.

[00:36:29] From a legal standpoint, this adds so many additional problems.

[00:36:33] Because drug possession and dealing legal penalties are a direct reflection of the current scheduling in place.

[00:36:42] Hence why there are so many people in prison because they were using or selling cannabis.

[00:36:48] And I would venture to say that the racial breakdown of those cannabis dealers in prison does not come out to be primarily white.

[00:36:58] We have it so ass backwards in America with drugs currently being investigated as therapeutics and with very low risk of fatality in LSD, ecstasy, and psilocybin as the highest scheduled drugs.

[00:37:13] It just doesn't make sense scientifically.

[00:37:18] I think the overall point of adding this piece to the end of our conversation, and why it's so relevant to the rest of part one,

[00:37:26] is that drug policy should be driven by scientific data, and it should not be driven by political aspirations.

[00:37:34] It should be meant to actually educate the public on the effects of different drugs that people are already using, instead of just fear-mongering.

[00:37:47] Let the data decide.

[00:37:50] Policy decisions should be made by scientists who are capable of evaluating large amounts of data, removing shitty data sets,

[00:37:59] and are not unjustly influenced by outside forces.

[00:38:02] Otherwise, our society and these decisions made at the highest levels of government are simply influenced by politicians trying to get re-elected,

[00:38:13] trying to appease their bases.

[00:38:15] Science doesn't care whose base it is.

[00:38:18] Science doesn't care about your opinion or my opinion on the matter.

[00:38:23] Data is data is data is data.

[00:38:26] And of course, some data is better than others.

[00:38:29] But when you get a good conscientious scientist who doesn't have skin in the game, other than just trying to get closer to the truth,

[00:38:37] and then we are allowing his voice to be silenced, his opinion to be demonized,

[00:38:45] that's where I have a big, big problem.

[00:38:48] And that's where we have to understand, as a general public,

[00:38:52] that some of these assertions being made at the highest levels of government

[00:38:56] are just not reflected or backed up by the science.

[00:39:00] Anyway, drugs are bad, but some drugs are worse than others.

[00:39:04] Hope you enjoyed part one and that you stick around for the next couple parts of my conversation with Ken Gilman.

[00:39:10] Thanks for listening.

[00:39:14] Somebody get this guy some help.

[00:39:24] We'll see you next time.

[00:39:24] Disclaimer.

[00:39:25] This podcast is for informational purposes only.

[00:39:26] The information provided in this podcast and related materials are meant only to educate.

[00:39:29] This information is not intended as a substitute for professional medical advice.

[00:39:32] While I am a medical doctor and many of my guests have extensive medical training and experience,

[00:39:35] nothing stated in this podcast nor materials related to this podcast,

[00:39:37] including recommended websites, texts, graphics, images, or any other materials,

[00:39:41] should be treated as a substitute for professional, medical, or psychological advice, diagnosis, or treatment.

[00:39:45] All listeners should consult with a medical professional, licensed mental health provider,

[00:39:47] or other healthcare provider if seeking medical advice, diagnosis, or treatment.

[00:39:51] Or, put more simply,

[00:39:53] If you need help like this guy, call your own doctor.

[00:39:57] Thanks again for watching and or listening.

[00:40:00] If you're passionate about the subjects that I discuss on the channel,

[00:40:04] do me a favor and like, comment, subscribe.

[00:40:09] Do whatever you can to make your voice heard

[00:40:12] that these are problems that must be addressed in our society.

[00:40:17] If you have any questions, comments, or concerns, I want to hear them.

[00:40:23] Feel free to reach out on social media or email us at renegadesyke at gmail.com.

[00:40:30] And if you'd like to be a guest of the show,

[00:40:32] or you have a connection to somebody that you think would be a good guest,

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[00:40:38] Thanks again for listening.

[00:40:40] все!

[00:40:40] Peace!

[00:40:41] Not puisque